Analysis on the cognitive function characteristics and changes in cerebral blood flow in young and middle-aged patients with mild cognitive impairment and white matter hyperintensities

YAN Yidan; ZHANG Yu; YANG Suxin; ZHANG Teng; ZHAO Li; TANG Tieyu; XU Xiaotian

doi:10.3969/j.issn.1674-3806.2024.06.08

Abstract：Objective To analyze the cognitive function characteristics and changes in cerebral blood flow in young and middle-aged patients with mild cognitive impairment(MCI)and white matter hyperintensities(WMH).Methods A total of 70 WMH patients,aged 35-65 years,admitted to Department of Neurology,Affiliated Hospital of Yangzhou University from February 2023 to December 2023 were recruited.Neuropsychological scale score,brain magnetic resonance imaging(MRI)and transcranial Doppler(TCD)examinations were performed in all the patients,and the patients'general clinical data were collected.According to the Beijing Version of Montreal Cognitive Assessment(MoCA)scores,the study subjects were divided into MCI group(with MoCA scores of 20-24 points,36 cases)and control group(with MoCA scores of 25-30 points,34 cases).The clinical baseline data,cognitive subdomain scores and TCD indicators were com-pared between two groups.Logistic regression analysis was used to explore the correlation between pulsatility index(PI)of middle cerebral artery(MCA)and the occurrence of MCI.Results The visual space and execute function,naming,attention,language,abstract thinking and delaved memory ability of MoCA in the control group were significantly better than those in the MCI group(P＜0.05).The long delayed recall scores and total scores of Auditory Verbal Learning Test-Huashan Version(AVLT-H)in the MCI group were lower than those in the control group,and the differences were statistically significant(P＜0.05).The scores of Verbal Fluency Test(VFT),Symbol Digit Modalities Test(SDMT)and Clock Drawing Test(CDT)in the MCI group were lower than those in the control group.The duration of Trail Making Test A(TMT-A)and Trail Making Test B(TMT-B)in the MCI group was longer than that in the control group,and the difference was statistically significant(P＜0.05).The PI level of MCA in the MCI group was higher than that in the control group,and the difference was statistically significant(P＜0.05).There were no statistically significant differences in the other TCD indicators(P＞0.05).After adjusting for gender,history of hypertension,history of diabetes,history of hyperlipidemia,history of smoking and history of alcohol drinking,the results of logistic regression analysis showed that the increased PI level of MCA was a risk factor for promoting the occurrence of MCI[OR(95％CI)=348.877(2.046-59 419.483),P=0.026].Conclusion The cognitive subdomain functions of language,visual space,memory,execution,attention and processing speed in young and middle-aged MCI patients with WMH are all reduced.The elevated PI level of MCA helps to identify the high-risk population.